Bexarotene
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Drug reference
colesevelam
Bile Acid Sequestrant · Antihyperlipidemic
Bile Acid SequestrantAntihyperlipidemic
CDSCO approved
EXCRETION
—
not curated
INTERACTIONS
5 major
SEVERE in our sources
PREGNANCY
B
FDA category + note
Top interactionssee all 10 →
- BexaroteneSevereDatabaseDDInter
- Mycophenolate MofetilSevereDatabaseDDInter
- Mycophenolic AcidSevereDatabaseDDInter
- TeriflunomideSevereDatabaseDDInter
Mechanism
Colesevelam is highly positively charged and binds negatively charged bile acids in the intestine, preventing their reabsorption and promoting excretion in stool. This depletes the bile acid pool, stimulating hepatic bile acid synthesis and increasing LDL receptor production, which enhances LDL-C clearance from plasma. This effect is partially offset by enhanced cholesterol synthesis.
Indications
HyperlipidemiaLowering LDL-C in patients with hypertriglyceridemiaTreatment of type 2 diabetes (as an adjunct to diet and exercise)Hypercholesterolemia
Dosing
- Adult
- Starting dose is either 3 tablets (0.625g each) taken twice daily with meals or all 6 tablets taken once daily with a meal. Maximum daily dose is 7 tablets (4.375 g).
Side effects
Common
Constipation (may be prevented by adequate daily water intake and psyllium)Less likely than colestipol to cause dyspepsia, bloating, and constipationConstipationDyspepsiaAbdominal painNausea
Pregnancy & lactation
Pregnancy
B
Drug interactions
Mycophenolate Mofetil
Severe
Database
Drug interaction classified as: absorption
Source: DDInter
Mycophenolic Acid
Severe
Database
Drug interaction classified as: absorption
Source: DDInter
Teriflunomide
Severe
Database
Drug interaction classified as: absorption, metabolism
Source: DDInter
Ursodeoxycholic Acid
Severe
Database
Decreased efficacy of ursodeoxycholic acid.
Administer ursodeoxycholic acid at least 2 hours before or 4-6 hours after colesevelam. Monitor for therapeutic effect.
Ethinyl Estradiol
Moderate
Textbook
Altered plasma levels and efficacy of ethinyl estradiol, potentially reducing contraceptive effect.
Source: G&G 14e · p1041
Fat Soluble Vitamins
Moderate
Textbook
Reduced absorption of fat-soluble vitamins (A, D, E, K).
Source: G&G 14e · p1041
Glyburide
Moderate
Textbook
Altered plasma levels and efficacy of glyburide, potentially affecting glycemic control.
Source: G&G 14e · p1041
L Thyroxine
Moderate
Textbook
Altered plasma levels and efficacy of L-thyroxine.
Source: G&G 14e · p1041
Verapamil
Moderate
Textbook
Reduced exposure and efficacy of sustained-release verapamil.
Prudence suggests patients take other medications 1 h before or 3 to 4 h after a dose of colesevelam.
Source: G&G 14e · p738
2 additional low-confidence interactions hidden — those rows lack a documented mechanism or management plan in our sources.
Related guidelines
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ADA · Endocrinology · 2025
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RSSDI · Endocrinology · 2025
Vaccination in adults with diabetes
RSSDI · Endocrinology · 2024
Glucose monitoring in diabetes
RSSDI · Endocrinology · 2024
Heart failure in diabetes
RSSDI · Cardiology · 2023
Other Bile Acid Sequestrant drugs
Ask House about colesevelam
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: Goodman & Gilman 14e·Verified: 2026-05-10 · House clinical team